| NPI | 1992813570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDALEE S KRUEGER Office Mgr 972-699-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX L0877) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-12-23 |